- Nearly 2 years into the COIVD-19 pandemic, the Biden administration has a new plan for trying to curb at-school outbreaks.
- A “test to stay” program will allow children to stay at school even if they’re exposed to the coronavirus.
- Experts say the best way to protect children against COVID-19 is by vaccinating them if they’re over age 5.
President Joe Biden announced his winter plan for COVID-19 on December 2. One strategy he emphasized was using “test to stay” (TTS) for schools, instead of quarantining close contacts of students with COVID-19.
“The CDC is now reviewing pioneering approaches like… ‘test to stay’ policies, which would allow students to stay in the classroom and be tested frequently when a positive case in that classroom popped up, and it wasn’t them,” Biden said.
“But rather than being sent home and quarantining, they’d be able to stay, because a test would be available,” he continued.
Let’s take a look at the details and how this program could help children avoid missed days of school while preventing disease spread.
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An important part of this strategy is that other prevention strategies, like universal masking are maintained to reduce the disease spread.
“I think taking steps to keep kids learning in person and participating in extracurricular activities is an absolute positive step,” Henry Bernstein, DO, MHCM, a pediatrician at Cohen Children’s Medical Center, New Hyde Park, New York, told Healthline.
But he emphasized that this doesn’t mean we shouldn’t continue using “tried and true” mitigation factors that we know work, “such as physical distancing, hand hygiene, the appropriate ventilation inside schools, [and] use of masks where appropriate.”
In March, Utah gave final approval to senate bill SB107, which allows those who test negative for COVID-19 with an antigen test during an outbreak to return to class, and those who test positive to stay home.
“These programs facilitated the completion of approximately 95 percent of high school extracurricular competition events and saved an estimated 109,752 in-person instruction student-days,” read the report.
Michael Grosso, MD, the chief medical officer and chair of pediatrics at Northwell Health’s Huntington Hospital in Long Island, New York, called Utah’s published experience with TTS “very promising.”
“We know that antigen tests are very helpful for detecting individuals who are likely to be infectious,” he said. “Molecular tests, like PCR, may be more sensitive, but individuals who are antigen-negative are very unlikely to spread the virus, even if they are infected.”
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However, results can take a few days to receive, since the test requires processing at a lab.
Antigen tests show results rapidly, but are less sensitive than PCR, work best when someone shows symptoms of COVID-19, and are conducted in the first 5 to 7 days of illness.
Bernstein said one way to counter reduced sensitivity is by increasing testing frequency.
“Even with the lower sensitivity of the antigen detection test, if you’re going to do it every day for example, that may overcome the lower sensitivity if you’re going to be checking each and every day,” he explained.
According to Grosso, every conceivable strategy for controlling the spread of the coronavirus has advantages and disadvantages.
“The ideal approach would protect all children from infection while eliminating all interruptions to in-person learning,” he said.
He noted that experts have been recommending approaches that come closest to achieving both goals for some time now: social distancing, masks, hand hygiene, and immunization.
Bernstein pointed out that vaccination is still the most effective strategy to ensure safety of students and staff in schools.
“I cannot emphasize enough how important it is for the unvaccinated to be vaccinated,” he said.
He added that mitigation factors (like mask wearing and social distancing) combined with different strategies, such as test to stay, “really can be of a benefit to students and families.”
Regarding Omicron, the most recent variant of concern to be identified, he said there isn’t enough information yet.
“But honestly, at this point, Delta is still the predominant strain,” he added. “And so we’ll go with that and once more data comes in with Omicron, we’ll decide what adjustments, if any, are appropriate.”
Part of Biden’s strategy against the pandemic this winter is “test to stay,” which involves testing rather than quarantining students who are close contacts of those who test positive for COVID-19.
Experts say that the rapid antigen tests used for this purpose aren’t as effective as PCR tests, but increasing testing frequency is one way around that problem.
They also say that, even with “test to stay,” people must continue using proven disease prevention measures, like wearing masks, social distancing, and getting vaccinated.